A patient in the emergency department says, The voices say ...

[dalyningkenk]

A patient in the emergency department says, The voices say someone is stalking me. They want to kill me because I developed a cure for cancer. I have a knife and will stab anyone who is a threat.
 
  Which aspect(s) of mental health should be of greatest immediate concern to the nurse? Select all that apply.
  a. Happiness
  b. Appraisal of reality
  c. Control over behavior
  d. Effectiveness in work
  e. Healthy self-concept

Question 2

A patient tells the nurse that his sexual functioning is normal when his wife wears short, red camisole-style nightgowns. He states, Without the red teddies, I am not interested in sex.. The nurse can assess this as consistent with:
 
  a. frotteurism.
  b. exhibitionism.
  c. fetishism.
  d. voyeurism.

[JYan]

Answer to Question 1

B, C, E
The aspects of mental health of greatest concern are the patient's appraisal of and control over behavior. The appraisal of reality is inaccurate. There are auditory hallucinations, delusions of persecution, and delusions of grandeur. In addition, the patient's control over behavior is tenuous, as evidenced by the plan to stab anyone who seems threatening. A healthy self-concept is lacking, as evidenced by the delusion of grandeur. Data are not present to suggest that the other aspects of mental health (happiness and effectiveness in work) are of immediate concern.

Answer to Question 2

C
To be sexually satisfied, a person with a sexual fetish finds it necessary to have some external object present, in fantasy or in reality. Frotteurism involves deriving sexual pleasure from rubbing against others surreptitiously. Exhibitionism is the intentional display of the genitalia in a public place. Voyeurism refers to viewing others in intimate situations.